Evidence from a broad investigation of horse-related accidents suggests that, while helmets prevent some injuries, they do not perform as well as they could, according to researchers.
Lauren Meredith, Robert Ekman, and Karin Brolin carried out a review of scientific literature relating to horse-riding and other horse-related injuries.
The trio noted that horse riding is a popular sport, typically considered to be a leisure activity.
Correspondingly, horse-related mishaps represent a sizeable proportion of patients going to hospital with injuries, with one study reporting an overall incidence rate of 23.7 hospitalizations per 100,000 persons per year and an overall death rate of 0.17 per 100,000 persons per year.
“In fact,” they reported in The Internet Journal of Allied Health Sciences and Practice, “it has been suggested, that horse riding is more dangerous than motorcycle riding.
“Furthermore, horse riding has been found to be the second most common sports-related cause of hospitalizations in adults and was responsible for the highest proportions of insurance claims due to adventure sports activities in New Zealand, being two times greater than mountain biking and four times higher than tramping, with three of the 27 fatalities due to horse riding accidents.”
Compared to a variety of other sports, the long-term consequences of injuries have been found to be the most prevalent in horse riding, soccer, and skiing.
Horse-related injuries are also over-represented in farm accidents, they noted, being responsible for 73% of injuries in the farm setting and represent the greatest proportion of injured and fatal patients presenting to hospital in New Zealand due to animal-related injuries.
The study team’s database search identified 151 relevant full-text articles, with 71 of these detailing the overall injury epidemiology of horse-related accidents.
These studies were primarily conducted in the United States and were based around reviewing hospital data, the trio from the Chalmers University of Technology in Sweden reported.
Of the 71 articles investigated, 60 suggested that those most frequently involved in horse-related accidents were young females, and 97% of papers that looked at injury mechanisms found falls from horseback were most often to blame.
It was suggested in multiple studies that these injury events mostly occurred in warm weather, when the horse behaved in an unexpected way.
Injury type and location varied depending upon how the injury occurred, but frequently involved the head and upper extremities. The most common injuries observed were fractures and soft tissue injuries.
Injuries to the head were reported by all relevant studies to be the most frequent cause of death.
“Some improvements in horse-related accident numbers and outcomes have been observed with the development and introduction of protective devices such as helmets and vests,” they reported.
“Yet despite the benefits of helmet and vest usage, there is evidence to suggest helmets do not perform as well as they could.
“There is a need to examine the level of protection afforded by these garments and where improvements in designs can be made.
“Current work,” they said, “is limited by the amount of information on the protective clothing worn by the horse-riders at the time of the accident, including specifics on the type of helmet and material properties.”
Further work could investigate improvements in safety measures and risk factors associated with fatalities, they said.
Reports regarding unmounted patients showed conflicting results, they said, which may be due to the variety of different tasks conducted around horses.
One report on unmounted injuries found being struck (56.6%) or crushed (25.6%) were the most common causes, with contusions/abrasions (40.8%) and fractures (18.9%) most common.
Most injuries for those not mounted (60.2%) involved the extremities.
Horse kicks to an unmounted equestrian typically resulted in facial injuries, sometimes severe, but have also been seen to cause major chest and abdominal injuries.
They also found that a substantial proportion of equestrians experienced long-term consequences after horse-related accidents.
Looking at fatalities, one study found that while 92% of deaths occurred during horse-riding accidents, 8% were caused by motor vehicles colliding with riders or horse-drawn vehicles.
Another study found that out of the 17 rider deaths investigated, 10 occurred while riding, two fell from the horse, two hit an object, one was hit by a car, and one was crushed. Two occurred as a direct result of equipment failure and one rider was dragged along behind the horse for a substantial period.
Of those unmounted, three were kicked, two occurred in traffic accidents, and two were trampled by the horse.
Meredith is a postdoctoral researcher in the Division of Vehicle Safety, within the Department of Mechanics and Maritime Sciences at Chalmers. Ekman is an Associate Professor in Public Health Science from Karolinska Institutet, Stockholm, and now serves as a researcher at Chalmers. Brolin is a Professor at the Division of Vehicle Safety at Chalmers.
Meredith L, Ekman R, Brolin K. Epidemiology of Equestrian Accidents: a Literature Review. The Internet Journal of Allied Health Sciences and Practice. 2018 Dec 14;17(1), Article 9.
The full review can be read here.